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Singulair vs Symbicort
Introduction
For patients with asthma or chronic obstructive pulmonary disease (COPD), certain drugs that alter the state of airways, reduce inflammation and dilate bronchial tubes can help in managing symptoms and improving breathing. Singulair and Symbicort are two such drugs that are often prescribed for these respiratory conditions. They each impact different aspects of lung function but both aim to enhance respiratory health in patients. Singulair is a leukotriene receptor antagonist, which works by blocking substances called leukotrienes to decrease swelling and tightening in the lungs, helping to alleviate asthma attacks. Symbicort, on the other hand, is a combination medication consisting of an inhaled corticosteroid (budesonide) and a long-acting beta agonist (formoterol). These work together to relax muscles around the airways while reducing inflammation within them.
Singulair vs Symbicort Side By Side
| Attribute | Singulair | Symbicort |
|---|---|---|
| Brand Name | Singulair | Symbicort |
| Contraindications | Should not be taken with certain types of antifungals or antibiotics without consulting a physician. Watch for psychological reactions such as agitation, aggression, anxiousness, dream abnormalities, and hallucinations. | Should not be taken if you are using certain types of antifungals or antibiotics without first consulting your physician. Watch for increased shortness of breath or wheezing immediately after use. |
| Cost | About $200 for a month's supply (30 tablets) of 10 mg, or about $0.15–$1 per day for the generic version | About $270 for one inhaler (120 doses at 160/4.5 mcg per dose), roughly $9/day if using two puffs daily. |
| Generic Name | Montelukast | Budesonide/Formoterol |
| Most Serious Side Effect | Mental/mood changes (such as agitation, aggression), trouble sleeping, sleep walking, abnormal dreams, suicidal thoughts. | Signs of allergic reaction or severe skin reaction, changes in vision, unusual changes in mood or behavior, severe problems with sleep, increased blood pressure, signs of high blood sugar. |
| Severe Drug Interactions | Certain drugs may need a period of time to clear from the system to prevent dangerous interactions. | Inform your healthcare provider about all medications you are taking to avoid potential drug interactions. |
| Typical Dose | Adults and adolescents 15 years of age and older: one 10 mg tablet per day. Children aged 6-14 years: one chewable 5 mg tablet per day. Young children aged between 2-5 years: a 4mg chewable tablet or granules once daily. | Begins with one inhalation of 80/4.5 mcg or 160/4.5 mcg twice daily, depending on severity. Dose can be adjusted but should not exceed two inhalations of 160/4.5 mcg twice daily. |
What is Singulair?
Montelukast (the generic name for Singulair) was the first drug of its class, leukotriene receptor antagonists, which represented a significant advancement from previous asthma medications. Montelukast received FDA approval in 1998 and works by blocking substances in the body called leukotrienes that cause narrowing and swelling of airways in the lungs. It is prescribed primarily for long-term treatment of asthma and to relieve symptoms of seasonal allergies. Singulair has a primary influence on leukotrienes with minimal impact on other areas, resulting in fewer side effects compared to other drugs that have broader effects.
On the other hand, Symbicort, whose active ingredients are budesonide (a corticosteroid) and formoterol (a bronchodilator), shows dual action: it reduces inflammation while also relaxing muscles around the airways to ease breathing. This combination makes Symbicort more effective at managing severe or chronic cases of asthma or COPD than Singulair would be.
What conditions is Singulair approved to treat?
Singulair is approved for the treatment of a range of respiratory conditions:
- Asthma and prevention of exercise-induced bronchoconstriction in patients 6 years of age and older
- Seasonal allergic rhinitis in patients 2 years and older
- Perennial allergic rhinitis in patients 6 months and older
On the other hand, Symbicort is used for:
- Maintenance treatment of airflow obstruction in patients with chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema
- Treatment of asthma in patient's six years or older not adequately controlled on a long-term asthma control medication.
How does Singulair help with these illnesses?
Singulair aids in managing symptoms of asthma and allergies by blocking the action of leukotrienes, inflammatory chemicals produced in the body. When released, leukotrienes can cause tightening of airway muscles and production of mucus and fluid - factors contributing to asthma symptoms such as shortness of breath, wheezing, coughing, and chest tightness. By inhibiting these substances with Singulair, patients can experience a reduction in inflammation within their lungs thus helping control their condition.
On the other hand, Symbicort works differently as it contains two active ingredients: budesonide (a corticosteroid) that reduces inflammation; and formoterol (a long-acting bronchodilator) which relaxes muscles around your airways to prevent or relieve bronchospasm. This combination helps manage both ongoing breathing difficulties while also acting quickly for sudden worsening or 'flare ups' making it versatile for various needs related to asthmatic conditions.
What is Symbicort?
Symbicort is a brand name for the combination of budesonide and formoterol. Budesonide is a corticosteroid that works by reducing inflammation in the body, while formoterol belongs to the class of drugs known as long-acting beta-adrenoceptor agonists (LABAs), which help to relax muscles in the airways to improve breathing. First approved by the FDA in 2006, Symbicort functions differently from leukotriene receptor antagonists like Singulair.
Unlike Singulair, Symbicort does not block leukotrienes but instead acts directly on inflamed tissues and bronchial smooth muscles. This dual action makes it effective at managing asthma symptoms and preventing flare-ups. The side-effect profile differs too; common side effects include throat irritation or pain, coughing, and dry mouth rather than tiredness or fever often seen with Singulair usage. Importantly for many patients who do not find sufficient relief using single-agent therapies such as Singulair alone, Symbicort can offer an additional therapeutic option.
What conditions is Symbicort approved to treat?
Symbicort is a medication that has been approved by the FDA for treatment of:
- Asthma in patients 6 years and older
- Chronic Obstructive Pulmonary Disease (COPD), including chronic bronchitis and emphysema
How does Symbicort help with these illnesses?
Symbicort is a combination medication that works to manage and prevent symptoms of asthma and chronic obstructive pulmonary disease (COPD). It contains two active ingredients: budesonide, which reduces inflammation in the lungs; and formoterol, which relaxes muscles in the airways. This dual action helps improve breathing by reducing swelling and relaxing muscles in your airways. Its effects on both bronchial inflammation and bronchoconstriction may play roles in its efficacy as a respiratory therapy.
In contrast, Singulair acts primarily by blocking leukotrienes, substances that trigger lung inflammation. While it's effective for some patients, others may find they respond better to Symbicort due to its broader range of action on the pathophysiology of respiratory diseases. Indeed, Symbicort might be preferred when patients do not respond well to medications like Singulair or it could be combined with such drugs for more comprehensive control over symptoms.
How effective are both Singulair and Symbicort?
Both montelukast (Singulair) and budesonide/formoterol (Symbicort) are efficacious in managing asthma symptoms, though they were approved by the FDA several years apart and operate via different mechanisms. Montelukast is a leukotriene receptor antagonist used for maintenance treatment of asthma and to relieve symptoms of seasonal allergies, while Symbicort is a combination product that includes both a corticosteroid (budesonide) and a long-acting beta agonist (formoterol).
A 2009 study directly compared these two drugs' effectiveness in controlling asthma symptoms; the results showed comparable efficacy between them with similar safety profiles. No significant differences were observed among studied metrics measuring symptom control in patients receiving either Singulair or Symbicort.
A review published in 2010 highlighted montelukast's effectiveness beginning from the first week of treatment, its favorable side effect profile compared to many other alternatives, and its tolerance even amongst pediatric populations. The same study reported that it has become one of the most widely prescribed medications for long-term management of asthma worldwide due to its ease of use as an oral medication.
On the other hand, studies on Symbicort suggest it may be more effective than placebo at controlling severe asthma attacks necessitating hospital visits or systemic steroid use. While often considered as an initial treatment option for moderate-to-severe persistent asthmatics alongside inhaled corticosteroids or those who require both components present in this combination therapy due to uncontrolled symptoms on single-agent therapy alone. Nonetheless, due to potential risks associated with long-acting beta agonists like formoterol when used without concurrent steroid therapy - something not applicable when using combined products such as Symbicort - selection should be carefully tailored based on individual patient needs including severity level plus presence/absence of concomitant conditions like COPD.
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At what dose is Singulair typically prescribed?
Dosages of Singulair for adults and adolescents 15 years of age and older is one 10 mg tablet per day. For children aged 6-14 years, the recommended dose is one chewable 5 mg tablet per day. For young children aged between 2-5 years, there's a 4mg chewable tablet or granules available to be taken once daily. In contrast, Symbicort dosage depends on the severity of asthma or COPD but typically it's two inhalations twice a day for adults (morning and evening). Adolescents and children over six can take two inhalations in the morning as well as at night depending on their condition. The maximum daily dosage should never exceed four inhalations twice a day.
At what dose is Symbicort typically prescribed?
Symbicort treatment typically begins with one inhalation of 80/4.5 mcg or 160/4.5 mcg twice daily, depending on the severity of your asthma or COPD. The dose can then be adjusted based on how well your symptoms are managed, but should not exceed two inhalations of the higher strength (160/4.5 mcg) twice daily, spaced approximately 12 hours apart. If you do not experience an improvement in breathing after a couple weeks of consistent use at this dosage level, consult with your healthcare provider for further evaluation and adjustment of medication regimen.
What are the most common side effects for Singulair?
Common side effects of Singulair include:
- Headache
- Stomach pain, heartburn or upset stomach
- Nausea, diarrhea
- Flu-like symptoms such as a stuffy nose, sore throat, and fever
- Coughing
- Dizziness
- Fatigue or feeling tired
On the other hand, Symbicort can cause a different set of side effects like:
- Throat irritation
- Hoarseness and voice changes
- Severe coughing or wheezing immediately after using the drug
- Rapid heartbeat (tachycardia)
-Nervousness
-Sinusitis
-Signs of an upper respiratory tract infection.
Always seek medical assistance if you experience any unusual symptoms while taking these medications.
Are there any potential serious side effects for Singulair?
While Symbicort and Singulair are both used to control and prevent symptoms caused by asthma, they do have different potential side effects. For Symbicort, these can include:
- Fast or irregular heartbeat
- Elevated blood pressure
- Allergic reactions: rash, itching/swelling (particularly of the face/tongue/throat), severe dizziness, trouble breathing
- Symptoms of pneumonia such as fever, persistent cough, chest pain
- Signs of high blood sugar like confusion, feeling thirsty all the time, increased urination or sudden weight loss.
Singulair users should be aware that while it's generally well tolerated it does carry a risk for certain serious side effects including:
- Mental/mood changes (such as agitation, aggression)
- Trouble sleeping
- Sleep walking
- Abnormal dreams
- Suicidal thoughts.
If you notice any signs of these adverse effects whilst taking either medication stop their use immediately and seek urgent medical advice.
What are the most common side effects for Symbicort?
Symbicort, while effective for conditions like asthma and COPD, has its own range of potential side effects. Some individuals may experience a dry mouth or sore throat as well as occasional stuffy nose. In some cases, it can cause blurred vision or ringing in the ears. Gastrointestinal issues such as nausea, vomiting, stomach pain are possible; loss of appetite and constipation might also occur. Sleep problems including insomnia can be a result too. Physical manifestations could include tremors and sweating whereas emotional responses may involve feelings of anxiety or nervousness. Fast heartbeat is another symptom to look out for along with states of confusion, agitation or hostility in severe instances. Other less common but noteworthy side effects include skin rash, weight fluctuations (both gain and loss), increased urination frequency, headache (or dizziness), and muscle or joint pain.
Are there any potential serious side effects for Symbicort?
While Symbicort is generally well-tolerated, some individuals may experience serious side effects. If you notice any of the following symptoms after starting treatment with Symbicort, seek medical attention immediately:
- Signs of allergic reaction or severe skin reaction: rashes or hives, itching, fever, swollen lymph nodes, difficulty breathing, swelling in your face or throat
- Changes in vision such as blurred vision and seeing halos around lights
- Unusual changes in mood or behavior including confusion
- Severe problems with sleep including insomnia
- Increased blood pressure: headache , chest pain , shortness of breath , irregular heartbeats
- Signs of high blood sugar like confusion , feeling sleepy , more thirst , more hungry
- White patches on tongue/in mouth Remember to inform your healthcare provider about all the medications you are taking to avoid potential drug interactions.
Contraindications for Singulair and Symbicort?
Both Singulair and Symbicort, along with other asthma medications, may cause a variety of side effects in some individuals. If you notice an increase in shortness of breath or wheezing after using these drugs, please seek immediate medical attention.
Neither Singulair nor Symbicort should be taken if you are using certain types of antifungals or antibiotics without first consulting your physician. Always inform your doctor about any medication that you are currently taking; certain drugs may need a period of time to clear from the system to prevent dangerous interactions with Singulair and Symbicort. Further, it's crucial not to stop or start either drug abruptly as it can worsen symptoms.
Additionally, both medications have been reported to cause psychological reactions such as agitation, aggression, anxiousness, dream abnormalities and hallucinations among others. Thus it is important for patients and caregivers to watch out for these signs while on treatment.
How much do Singulair and Symbicort cost?
For the brand name versions of these drugs:
- The price for a month's supply (30 tablets) of Singulair (10 mg) averages around $200, which works out to approximately $6.60/day.
- The cost for one Symbicort inhaler (120 doses at 160/4.5 mcg per dose) is about $270, working out to roughly $9/day if you use two puffs daily.
Consequently, if you are using the recommended dosage for each medication, then Singulair is less expensive on a per-day treatment basis compared to Symbicort. However, it’s important that cost isn’t your primary consideration in determining which drug suits your needs best as they have different mechanisms and indications.
Regarding generic versions—unfortunately, there isn't currently an available generic form of Symbicort; however:
- Montelukast sodium equivalent to Singulair is available in packs from 30 tablets and above with costs significantly lower than its branded counterpart: about $0.15–$1 per day depending upon the pharmacy and insurance coverage.
Please note again that while costs can be a factor when choosing between treatments, effectiveness and personal tolerance should also be taken into account along with advice from medical professionals.
Popularity of Singulair and Symbicort
Montelukast, most commonly known by its brand name Singulair, was estimated to have been prescribed to about 6.2 million people in the US in 2020. Montelukast accounted for just under 12% of prescriptions for medications used to manage asthma and allergies. As a leukotriene receptor antagonist, it works differently from traditional antihistamines or corticosteroids, which helps explain its popularity among those who do not respond well to other classes of medication. Its use has been steadily increasing since it was first approved by the FDA in 1998.
On the other hand, Budesonide/Formoterol Fumarate Di-hydrate (Symbicort) is an inhaler that combines two active ingredients: budesonide - a steroid that reduces inflammation; and formoterol - a long-acting bronchodilator that relaxes muscles in the airways to improve breathing. In the US alone, Symbicort was prescribed approximately 3.5 million times in 2020 accounting for around 15% of combined bronchodilator and steroid prescriptions specifically designed for treating asthma and chronic obstructive pulmonary disease (COPD). Similar with montelukast's growth pattern, Symbicort’s prevalence has also gradually increased over last decade due to its dual-action mechanism providing both immediate relief as well as preventing future exacerbations.
Conclusion
Both Singulair (montelukast) and Symbicort (budesonide/formoterol) have been extensively used in the management of asthma, with many clinical studies supporting their efficacy over placebo treatments. They may sometimes be used together to manage severe cases but this should always be under careful consideration by a physician due to potential interactions. Their mechanisms of action differ substantially; Singulair is a leukotriene receptor antagonist that reduces inflammation and bronchoconstriction, while Symbicort combines an inhaled corticosteroid (budesonide) which lessens airway inflammation, and a long-acting beta agonist (formoterol), which helps keep the airways open.
Singulair is typically considered as an add-on treatment when low-dose inhaled corticosteroids alone are not sufficient or for those who prefer oral to inhalant medication. On the other hand, Symbicort is commonly prescribed as first-line therapy for moderate-to-severe asthma or chronic obstructive pulmonary disease (COPD).
Generic versions are available for both drugs leading to cost savings especially pertinent for uninsured patients. The effects of both medications may take some time to become noticeable.
The side effect profiles are generally well-tolerated but do vary between them: Singulair can potentially cause mood changes and sleep disturbances whereas Symbicort might lead to throat irritation and increased heart rate among others. It's important that patients monitor any changes closely upon starting these therapies, seeking immediate medical attention if symptoms worsen significantly.
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Refrences
- Scicchitano, R., Aalbers, R., Ukena, D., Manjra, A., Fouquert, L., Centanni, S., … Hultquist, C. (2004, July 22). Efficacy and safety of budesonide/formoterol single inhaler therapy versus a higher dose of budesonide in moderate to severe asthma. Current Medical Research and Opinion. Informa UK Limited.http://doi.org/10.1185/030079904x2051
- Berger, W. E., & Noonan, M. J. (2010, May). Treatment of Persistent Asthma With Symbicort® (Budesonide/Formoterol Inhalation Aerosol): An Inhaled Corticosteroid and Long-Acting β<sub>2</sub>-Adrenergic Agonist in One Pressurized Metered-Dose Inhaler. Journal of Asthma. Informa UK Limited.http://doi.org/10.3109/02770901003725684
- Buhl, R. (2003, August). Budesonide/formoterol for the treatment of asthma. Expert Opinion on Pharmacotherapy. Informa UK Limited.http://doi.org/10.1517/14656566.4.8.1393
- Halpin, D. M. (2008, January). Symbicort: a pharmacoeconomic review. Journal of Medical Economics. Informa UK Limited.http://doi.org/10.3111/13696990802210984
- Bateman, E. D., Bantje, T. A., Gomes, M. J., Toumbis, M. G., Huber, R. M., Naya, I., & Eliraz, A. (2003, June). Combination Therapy with Single Inhaler Budesonide/Formoterol Compared with High Dose of Fluticasone Propionate Alone in Patients with Moderate Persistent Asthma. American Journal of Respiratory Medicine. Springer Science and Business Media LLC.http://doi.org/10.1007/bf03256655
- Ind, P. W., Haughney, J., Price, D., Rosen, J.-P., & Kennelly, J. (2004, May). Adjustable and fixed dosing with budesonide/formoterol via a single inhaler in asthma patients: the ASSURE study. Respiratory Medicine. Elsevier BV.http://doi.org/10.1016/j.rmed.2003.07.010
- Emami, M., Tayebi, A., Gharipour, M., Farzamnia, S., & Temyarti, A. (2014). Comparing clinical efficacy of Symbicort versus Pulmicort in reducing asthma symptom and improving its control. Advanced Biomedical Research. Medknow.http://doi.org/10.4103/2277-9175.127999